Community Health Status Assessment

Caroline Billings
Release Date- November 10, 2020
Review Date- March 7, 2022

The Patient Protection and Affordable Care Act (2010) requires tax hospitals to do a Community Health Needs Assessment (CHNA) every three years. CHNAs give hospitals and communities the chance to understand and address what factors might be influencing population health. Using the population health data and Community Health Development Approach to drive hospitals’ program and planning efforts is beneficial for understanding what is influencing the population health status to allow for more efficient allocation of resources and more accurate evaluations of the results. It is also beneficial to engage the community in the health assessment process to increase the resources available and the options for finding appropriate solutions to problems.

The goal outcomes of the Community Health Development Approach are improving the population’s overall health status and increasing the community’s capacity to handle health issues. In addition, collaborating with other local agencies or programs with similar requirements for their community health assessments provides an opportunity for relationship-building and networking for future endeavors.

Community Assessment Processes

  • Components of a Health Status in Community Health Assessment and Improvement Plans
    • Ecological Factors– policies, social determinants, community/ population characteristics
    • Community Capacity for Health Status Improvement– social capital, supporting functions
    • Health Care System– access, quality, financing, and delivery of healthcare
  • Methods for Understanding Population Health When Assessing
    • Ensure that the hired consultant holds Community Discussion Groups with a wide variety of audiences and asks questions such as-
      • How do you describe your community?
      • What are the challenges facing the community?
      • What are local resources addressing these issues and challenges?
      • What are examples of local collaboration to solve problems?
    • Ensure that the consultant holds individual interviews with community leaders, healthcare leaders, and members of the community.
    • Ensure that secondary data collection and analysis are assessed.
      • Data from state and local agencies is examined to incorporate other data gathered into the Community Health Assessment, such as Key health indicators (HP2010), Demographic information for the area of interest, and Comparisons of the local area of interest to the state, for indicators such as disease or health risks
      • Reliable Sources for Secondary Data
    • Conduct a general population survey using a random sampling methodology. Include questions regarding the community’s-
      • Demographics (differences in income, race, ethnicity, and age), functional health status/health-related quality of life, chronic conditions and disabilities, risks to poor health from individual behaviors, preventative screening participation, characteristics of a ‘regular provider,’ challenges of accessing services, insurance (coverage, history of lack of insurance), social capital measures, sources and perceptions of regular care (inpatient/outpatient), use of an emergency room for care, readiness to change and counseling received from the regular provider, need for supportive community services, and issues of concern.
  • Challenges and Tricks of Community Needs Health Assessments
    • Increasing costs for conducting surveys- Assess recent (1-year-old) secondary data collected by local and state agencies to establish a baseline before collecting data on topics that may have already been discussed within the community.
    • Qualitative data is critical, but focus groups are not community discussion groups. Focus groups were designed to focus on specific aspects of the community’s health rather than openly discussing other potentially critical factors affecting the population. They must be more structured than community discussion groups and must have recordings, an infrastructure background, and videotaping. Community discussion groups generate richer data.
    • Secondary data is a rapidly developing resource that allows increased access to data acquired by other agencies.

Selection of an Assessment Consultant

  • When hiring a consultant, ask questions about their-
    • Formal training about how to best conduct a Community Needs Assessment. This competency can be assessed by viewing the job requirements of the consultant’s job firm or agency.
    • Practical experience in Community Needs Assessments
      • Do they understand that two communities are never the same even if their demographics look similar?
      • Do they have a sense of community?
      • Do they have a sense of how the community works?
      • Pay attention to the types of questions the consultant asks you about your community while interviewing.

Sharing Assessment Findings with Your Community

  • The gathered Community Health Status Data can be shared in many ways with your community. For example, through program/service planning, grant writing, community benefits documentation, accreditation, HEDIS reporting/JCAHO requirements, Health Professional Education (training and continuing education), physician (and other staff) recruitment, contracting with Medicaid and Medicare, capitation (or other financings), estimation of pooled risk, strategic and market planning, and program/service evaluation.
  • When sharing the newest findings from the Community Health Assessment, compare them to the findings of prior Community Health and Needs Assessments. Share the improvements and the findings that indicate a need for refinement.

Resources- Community Health Assessment Toolkit – This link leads to a toolkit comprised of Action Steps your hospital can take to efficiently and effectively use the results of your CHNA.